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Since D2HG and L2HG are indistinguishable in standard LC-MS, to determine which 2HG enantiomer(s) is affected, we adapted a chiral N-(p-toluenesulfonyl)-L-phenylalanyl chloride (TSPC) derivation followed by liquid chromatography with tandem mass spectrometry (LC-MS/MS) analysis 24,40
Of note, integrating TCM into standard care was constrained by methodological limitations (e.g., small sample sizes, non-RCT designs), mechanistic ambiguity, and quality control issues, necessitating large-scale randomized trials, ingredient standardization, and safety evaluations to facilitate evidence-based implementation
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Patient populations show distinct preferences based on medical needs and risk factors
